Post-inflammatory hyperpigmentation (PIH) is common and challenging condition seen more frequently in skin of color. The aim of this study was to characterize PIH clinically and histopathologically using photography, colorimetry, spectrophotometry, a survey, and skin biopsy evaluation. Twenty-three subjects (18 African American, 3 Asian, and 2 White) were enrolled in this single-center, prospective pilot study. Acne was the most common cause of PIH in African Americans, followed by psoriasis and atopic dermatitis in Asians, and other causes in White participants. Colorimeter analysis revealed that deltaL* (ΔL*) between PIH and normal skin did not differ by cause of PIH but did by racial/ethnic group, with African Americans having the smallest ΔL* followed by Asian and then White participants. Compared to normal skin, PIH skin showed an increase in hyperkeratosis, acanthosis, elongation of rete ridges, mid-dermal and interstitial inflammation, plasma cells, dermal fibrosis, and dermal melanophages. Immunohistochemical staining showed PIH skin had increased staining for CD3, CD20, CD68, and melanin. For hyperpigmentation secondary to acne, atopic dermatitis, and psoriasis, persistent dermal and interstitial inflammation suggests the inflammatory process may be ongoing even after the primary condition has clinically resolved, representing persistent and inflammatory hyperpigmentation (PAIH). The proposed concept of PAIH has potential therapeutic implications, including exploration of the continued use of anti-inflammatory treatments for PAIH.
Postherpetic neuralgia (PHN) is a debilitating complication of herpes zoster (HZ), yet reliable biomarkers for early prediction remain elusive. This study aimed to evaluate the predictive value of serum Galectin-3, Galectin-9, and IL-6 levels for PHN development. In this prospective cohort study, a total of 76 participants were enrolled in this prospective cohort study, including 56 patients with acute herpes zoster (HZ) and 20 healthy controls. Based on 3-month follow-up outcomes, the HZ patients were further divided into two groups: those who developed postherpetic neuralgia (PHN group, n = 18) and those who did not (non-PHN group, n = 38). The patients were followed up to evaluate the development of PHN. Serum levels of Galectin-3, Galectin-9, and IL-6 were quantified via ELISA. Receiver operating characteristic (ROC) curves and multivariate Cox regression analyses were employed to assess biomarker performance and independent predictors of PHN. Baseline serum levels of all three biomarkers were significantly elevated in patients who subsequently developed PHN compared with both non-PHN patients and healthy controls (all P < 0.01) and were strongly correlated with pain severity (NRS scores; ρ = 0.68–0.75, P < 0.001). ROC analysis identified Galectin-9 as the strongest predictor of PHN (AUC = 0.85, sensitivity = 94.4
This study aimed to explore the efficacy and safety of the 1064-nm Nd: YAG picosecond laser in the treatment of xanthelasma palpebrarum. Patients with xanthelasma palpebrarum were enrolled and scheduled to undergo at least three sessions of 1064 nm Nd: YAG picosecond laser treatment with a 4-week interval. Clinical efficacy was independently assessed by two dermatologists using a six-grade scale(0–5). Patients were asked to rate the degree of pain related to treatment on a visual analog scale (VAS), with scores ranging from 0 (no pain) to 10 (worst pain ever). We enrolled 13 patients (12 female and one male) with 36 lesions between March and December 2022. The mean clearing grade after one treatment session was 1.7, which increased to 2.2 after two treatment sessions. After three treatment sessions, the mean clearing grade was 3. In four patients who received four treatment sessions, the mean clearing grade further increased to 3.7. The mean VAS score for pain was 4.28. Purpura and bleeding resolved within one week. Dyschromia or scarring was not observed. The 1064-nm Nd: YAG picosecond laser is effective and safe for the treatment of Xanthelasma palpebrarum. Trial Registration: chictr.org.cn Identifier: ChiCTR2200063203.
Acne-induced macular dyspigmentation, is a common and distressing sequela of acne. These marks can be long-lasting and disproportionately affect individuals with darker skin types. Explore the lived experience of acne-induced macular dyspigmentation, including its effects on mental health, social functioning, and treatment experience. Semi-structured interviews were conducted among individuals aged 12–45 with acne-induced macular dyspigmentation, recruited from Brigham and Women’s Hospital and Boston Children’s Hospital. Transcripts were reviewed and coded by two independent reviewers. Eighteen individuals with a mean age of 25.9 (SD 8.9, range 14–43) participated, of whom 14 (78
